Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy

被引:182
作者
Bruera, D
Luna, N
David, DO
Bergoglio, LA
Zamudio, J
机构
[1] Natl Univ Cordoba, Sch Med Sci, Hosp Nacl Clin, Dept Endocrinol, Cordoba, Argentina
[2] Natl Univ Cordoba, Sch Med Sci, Hosp Nacl Clin, Endocrinol Lab, Cordoba, Argentina
[3] Rawson Hosp, STD AIDS Unit, Cordoba, Argentina
关键词
bone mineral density; osteopenia; osteoporosis; HIV infection; AIDS;
D O I
10.1097/00002030-200309050-00010
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies. Design: Cross-sectional analytical study. Method and materials: A total of 142 subjects (113 male, 29 female), aged 20-45 years were divided into four groups: group A, 33 HIV-seropositive anti retroviral-naive patients; group B1, 36 HIV-seropositive patients on antiviral therapy for over 1 year, without protease inhibitors (PI); group B2, 42 HIV-seropositive patients on combined therapy containing PI for over 1 year; and group C, 15 healthy, HIV-seronegative subjects. Bone mineral density (BMD) were determined by dual energy X-ray absorptiometry in total body, lumbar spine and proximal femur; and evaluation of serum osteocalcin, D-pyridinoline, parathyroid hormone (THP), calcium and phosphate, and urine calcium. Results: BMD was significantly lower in HIV-seropositive patients in comparison with healthy controls, in all sites studied. However, no statistical differences were observed among all groups of HIV-infected patients, independently of the antiretroviral therapy. There was a significantly higher occurrence of osteopenia and osteoporosis in HIV-infected patients in comparison with controls (P < 0.0001), with no differences among treatment-naive patients and either of the treatment groups. Bone formation and resorption markers were similar among all studied groups. There was a significant correlation in all bone sites between time of infection and BMD (P < 0.02). Conclusions: BMD was significantly lower in HIV-seropositive patients in comparison with controls in lumbar spine, proximal femur and total body, without significant differences among treatment-naive patients and either of the treatment groups. Only time with HIV infection and not specific therapy was associated with BMD decreases. (C) 2003 Lippincott Williams Wilkins.
引用
收藏
页码:1917 / 1923
页数:7
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